Prevalence of non-alcoholic fatty liver disease on computed tomography in patients with inflammatory bowel disease visiting an emergency department

Alisa Likhitsup; Jason Dundulis; Shaya Ansari; Hani El-Halawani; Randal Michelson; Colleen Hutton; Kevin Kennedy; John H. Helzberg; Rajiv Chhabra

Authors Alisa Likhitsup, Jason Dundulis, Shaya Ansari, Hani El-Halawani, Randal Michelson, Colleen Hutton, Kevin Kennedy, John H. Helzberg, Rajiv Chhabra.

Abstract

Background Non-alcoholic fatty liver disease (NAFLD) is common in patients with inflammatory bowel disease (IBD). The purpose of this study was to further examine the prevalence of NAFLD in IBD patients.

Methods We retrospectively reviewed the medical records of IBD patients who visited the emergency department because of abdominal pain between January 2009 and December 2014. These were compared with a group of 70 controls without IBD, matched for age and body mass index (BMI). Computed tomography data were analyzed for the presence or absence of hepatic steatosis. Patient with recent steroid or excessive alcohol use were excluded. Univariate and multivariate analyses were performed.

Results NAFLD prevalence was 44% (31/70) in the IBD group vs. 16% (11/70) in controls (P<0.001). There was no significant difference between the 2 groups in age, sex distribution, BMI, presence of diabetes, or levels of serum transaminases, serum albumin or platelets. In multivariate analysis, the presence of IBD was independently associated with NAFLD (odds ratio 4.53, 95% confidence interval 2.00-10.26; P=0.002).

Conclusions The presence of IBD is strongly and independently associated with NAFLD. Systemic inflammation and alteration of the intestinal microbiome have been proposed as mechanisms, but further studies are needed to better elucidate the pathophysiology.

Keywords Hepatic steatosis, inflammatory bowel disease, non-alcoholic fatty liver disease

Ann Gastroenterol 2019; 32 (3): 283-286